Hold2 Profile picture
27 Mar, 22 tweets, 13 min read
Thread: Masks and NPIs.

This thread reviews information published from Oct 2019 - Dec 2020.

The point is to see what was known/believed before & after discovery of COV2.

We'll start with research on epidemic/pandemic influenza (flu) from Oct of 2019.

Aerosols vs. droplets.
/1 ImageImageImage
Seasonality? This was actually a known phenomenon?

/2 ImageImageImage
Intended impact of NPIs.

Does this look familiar? This published in October of 2019 - that's very interesting to me.

Why does this "flatten the curve" image always go to 0 with no resurgence and not have values on either axis?

Let's look at NY and FL for fun.

/3 ImageImageImage
Evaluation of the evidence.

Order of quality (best to worst):
1) Randomized Controlled Trials (RCTs)
2) Observational Studies
3) Computer Simulations

How many RCTs have been done since COV2? None? DANMASK?

How about the CDC review of 14 RCTs covering NPIs in the community?

/4 ImageImage
Summary of Recommendations.

Masks?

For Asymptomatic:

Conditionally recommended "although there is no evidence that this is effective in reducing transmission"

For Symptomatic:

Recommended always despite no evidence

Why? Mechanistic plausibility.😐

/5 Image
Surface and object cleaning?

Recommended at all times "although there is no evidence this is effective in reducing transmission."

Why? Mechanistic plausibility.😐

Contact tracing?

NOT RECOMMENDED

/6 ImageImage
Quarantine/Isolation?

Sick Individuals:

Recommended at all times but very low quality of evidence.

Exposed Individuals (not sick):

"no obvious rationale for this measure"

NOT RECOMMENDED

/7 Image
School measures and closures?

Conditionally recommended with very low quality of evidence.

Should only be for a limited period of time with all adverse effects fully considered first.

/8 Image
Personal Protective Measures.

Hand Hygiene?

Apparently, RCTs have not found hand hygiene to be effective against flu in community settings. I did not know this. Did you?

This only works theoretically and experimentally, so again its down to mechanistic plausibility.

/9 ImageImageImageImage
Masks?

"There was no evidence that face masks are effective in reducing transmission of laboratory-confirmed influenza."

Why then does this same entity conditionally recommend wearing of masks by asymptomatic people?

"mechanistic plausibility."

No mention of the harms.

/10 ImageImageImageImage
Now, we jump to May 2020.

Different entity saying the same thing.

"these measures did not support a substantial effect on transmission of laboratory-confirmed influenza"

Despite what? Mechanistic plausibility...

/11 ImageImage
What changed for COV2? Why did Fauci say masks should not be worn only to then do a 180* and start acting like they were magic?

This defied all known science except "mechanistic plausibility."

Did they all mistake correlation for causation while ignoring seasonality?

/12 ImageImageImageImage
1 month later to June 2020.

By now, masks had gone from obscure to mandated for general public.

This is acknowledged while stating such mask usage is not supported by evidence.

However, it still recommends masks due to...correlation seen in recent observations (Mar-May).

/13 ImageImageImage
Evidence?

None for "the effectiveness of universal masking of healthy people in the community to prevent infection with respiratory viruses"

Potential Benefits?

"reduced potential exposure"

Then
- Reduced stigmatization
- Virtue
- Compliance
- Source of income

😐

/14 ImageImageImage
Potential Harms?

- Self-contamination due to touching mask and face/eyes
- Self-contamination due to improper use, amplifying microorganism growth
- Headaches / breathing difficulties
- Skin lesions
- Communication, especially children, deaf, & developmentally challenged

/15 Image
Now, Dec 2020. Did anything change?

Evidence?

No new supporting evidence, but the language was changed from

"there is no direct evidence"

to

"there is only limited and inconsistent scientific evidence"

Basically...there's no evidence, but we keep recommending anyway.

/16 Image
Benefits?

Mostly the same except they reworded the "compliance" bullet. Still have virtue listed.

It specifically references reduced spread of "droplets" without mentioning aerosols.

Also claims masks prevent TB and Flu but does not provide a reference with evidence.

/17 Image
Harms?

2 strange changes:

1) First, both of the "self-contamination" bullets were removed. Why? There went from first on the list to non-existent

2) Added a very interesting one: "a false sense of security"

/18 Image
Guidance?

In the end, "despite the limited evidence of efficacy of mask wearing in community settings," they still advise mask wearing.

😐

/19 Image
This is enough to force children to wear masks of random materials for many hours each day?

This is enough to scare people into not only wearing masks wherever they go but even wearing 2?

We must stop. Don't be fooled. Don't let yourself be coerced into compliance.

/20
References.

WHO (Oct 2019):
apps.who.int/iris/bitstream…

CDC (May 2019):
wwwnc.cdc.gov/eid/article/26…

WHO (Jun 2020):
apps.who.int/iris/bitstream…

WHO (Dec 2020):
who.int/publications/i…

/END
BONUS

In the vein of "correlation-as-causation" with observational studies, this happened in November.

A team at UCSF, including @MonicaGandhi9 - who I wish to enter a dialogue with - withdrew a pre-print that was originally going to correlate mask mandates w/ decreased Hosps. https://www.medrxiv.org/con...

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More from @Hold2LLC

7 Oct
Answering you, we strictly did homeschooling last year because of being failed by state leadership and our local public school district.

We outsourced the curriculum development AND teaching (via tutoring). It was a preferable alternative but was not awesome.

This year...

/1
We continued because 2 of our 3 kids preferred it and did not want to go back, so we improved our situation by joining a co-op where they still interact with many other kids, do extracurricular activities, never see a single mask, and get exposure to much better curricula...

/2
The co-op set the curricula and progress/milestones, but it's completely up to me to decide what we follow, what we use, how intense we do it, and how best our 3 kids learn.

So far, it's even better and is working very well. Our girls get to train (equestrian) much more...

/3
Read 4 tweets
13 Sep
Homeschool Update: Year 2

Last year, we pulled our kids from NY public schools at the last minute, because we would not accept only 2d/wk of in-person teaching and would not accept our kids to be forcibly masked.

We thought for sure we'd be able to return this year, but...

/1
As CoV2 numbers dropped seasonally (Jan-May) along with rising vax rates, we felt confident we'd see normal conditions (no masks, quarantine, distancing, etc.).

I asked their preferences:
-Twins chose to continue homeschool
-High-schooler chose to return but only if no masks

/2
Over the summer, things got crazy with Cuomo's scandal. He and NYS DOH did not announce new school guidance while school districts scrambled to respond to angry parents.

Eventually, DOH quietly emailed Superintendents stating they could make masks optional for summer school.

/3
Read 8 tweets
7 Jul
NY School Masking - Master Thread: Summer/Fall 2021

Gov Cuomo and NYS DOH left school districts confused when removing the State of Emergency without clarifying school mask rules.

This thread shows School Districts where masks are proactively made optional:

#1 - Depew Image
#2 - Hamburg

Same wording. Note these districts are matching up summer school with summer camp guidance.

Key quote:

"...there is no material difference in risk levels or populations between our programs and summer camps." Image
#3 - Tonawanda

Same text again.

Notable logic:
- Cuomo lifted the state of emergency
- NYSDOH, NYSED, and CDC guidance documents only covered the '20-'21 school year, which ended
- Legal counsel agreed with the logic
- Will re-evaluate if NYS issues new guidance Image
Read 8 tweets
3 Jul
Well, it looks like this is the end. We thought it was over when CTP stopped, but then @TheLawyerCraig and his merry band of data volunteers kept us going for 4 more months.

In commemoration, we will post our final chart set.

First, Reported Cases & Hospitalization Census

/1
Same chart w/Hope-Simpson overlay.

- Summer stimulus visible again like last year, though 2 weeks later
- Cases bottomed on 6/18 and have risen since but much less than 2020
- Hosp Census followed trend this past week by hitting its inflection point and turning up slightly

/2
Reported Cases vs. Test Positivity

As is typically the case, Pos% inflected first with Reported Cases following shortly after.

Though turning up like 2020, the Pos% rate increase is much shallower and much lower overall.

/3
Read 6 tweets
26 Jun
US CoV2 Update: 6/26/21

Cases w/inflection points labeled. Summer stimulus with upward pressure has arrived.

As expected, amplitude is minimal.

Spring Peak:
- 2020: 4/13
- 2021: 4/12

June Trough:
- 2020: 6/10
- 2021: 6/18

Summer Peak:
- 2020: 7/23
- 2021: TBD

/1
Hospitalization Census w/inflection points labeled.

Summer stimulus showing the same as Cases but with slight lag.

Amplitude increase should be minimal.

Spring Peak:
- 2020: 4/21
- 2021: 4/21

June Trough:
- 2020: 6/20
- 2021: 6/25-28?

Summer Peak:
- 2020: 7/27
- 2021: TBD
/2
Reported Deaths w/inflection points labeled.

This pattern is much less aligned than Cases/Hosps.

That April 2020 spike appears abnormal beyond just the effects of CoV2 itself.

Notice how much closer the current numbers are.

Probably will see another July 4 reporting trough.
Read 4 tweets
12 Jun
***Master NY BOE Unmask🧵***

I've created this to gather all the NY BOE letters being sent to Gov Cuomo and Legislature.

It started with Hauppauge, a Long Island district that was open 5d/wk ALL YEAR. Yes, even in NY. They set the pace.

This is Science. This is Leadership. ImageImage
Then Massapequa jumped in the ring for tag team support while adding their own #RationalGround verbiage:

"We respectfully request that you either provide the data and science that supports the universal masking of our children, or you lift the mask mandates for schools."

🔥🔥🔥 Image
Next, the floodgates opened.

A scorcher from William Floyd.

"...masks are causing anxiety and mental anguish, along with physical issues such as nosebleeds and trouble breathing..."

How many times have you heard, "what's the harm?" or "well my kid doesn't mind wearing one"? Image
Read 25 tweets

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